Contracts/Credentialing Guidelines
Physicians, dentists, other health care and dental professionals and facilities must first complete a credentialing
application before they can participate in Regence
provider networks. Prior to submitting a credentialing application, please review the list of Provider
Types to determine if we contract with your specialty and if the network is open to participation. You may also sign up for eContracting, which allows you to receive notification of provider agreements and amendments through the convenience of your personal email. Learn more about eContracting and sign up.
Credentialing applications are usually processed within 45 days of receipt. During peak application periods (usually spring and summer) this processing time may increase. Please ensure that applications are completed in their entirety, are signed and all supporting documentation included as incomplete applications will delay processing time.
Participating Effective Date Policy
The following policy applies to all participating providers:
- New provider agreements will have an effective
date of the first day of the month in which the credentialing
was approved (e.g., if credentialing was approved
on June 14, the agreement will be effective on June
1).
- If a signed agreement is not received in the same
month as the credentialing is completed, the agreement
effective date will be the first of the month in
which credentialing is approved or the signed agreement
is received, whichever is later.
- A new provider joining a group or clinic agreement
will have an effective date of the first day of the
month in which he or she was credentialed (e.g.,
if credentialing was approved on June 14, the effective
date of participation will be June 1).
- If a provider already participating with Regence
adds an additional network, the effective date of
the new network will be the first day of the month
the signed agreement is received.
- Retroactive agreement effective dates are not permitted.
- Claims submitted for dates of service prior to
the agreement effective date will be processed as
out-of-network.
Contracting and Credentialing Forms
Note: The term “Practitioner” is used on credentialing forms and applications to identify physicians and other health care professionals.
Indian or Tribal Health Clinic credentialing requirements
We require that all Indian or Tribal Health providers
complete the credentialing process prior to contracting.
These providers are required to complete the recredentialing
process at a minimum of every three years.
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